Sørensen L V, Mors O, Skovlund O
Department of Neurosurgery, University Hospital, Arhus, Denmark.
Acta Neurochir (Wien). 1987;88(3-4):119-25. doi: 10.1007/BF01404148.
57 patients who underwent surgery for slipped lumbar disc for the first time were examined prospectively 6 months after surgery for the purpose of deciding the correlation between the outcome of surgery and social and psychological factors. The following factors were found to be of importance: Female sex, action for damages, prolonged disease of the back; prolonged, current attack, report of long-term illness, pathological pain producing, anxiety, depression and multiple somatic complaints revealed by Minnesota Multiple Personality Inventory (MMPI), severe pain reported immediately post-operatively, employment and the presence of complete herniation at surgery. A closer study revealed 3 factors which were important independently and which explained the other factors: Admission of symptom scale (Ad) in the MMPI, the duration of the current attack and whether the patient was employed. On this basis we define a group with severe psychological and social strain (PASS), 57% of which had a poor outcome. 5% of the rest of the patients had a poor outcome. With the pre-operative assessment of whether or not the patients are under severe psychological and social strain, the outcome of surgery could be predicted correctly in 86% of the patients.
对57例首次接受腰椎间盘突出症手术的患者进行前瞻性研究，在术后6个月进行检查，以确定手术结果与社会和心理因素之间的相关性。发现以下因素具有重要意义：女性、索赔行为、背部疾病病程延长；当前发作持续时间长、当前发作、长期疾病报告、病理性疼痛产生、焦虑、抑郁以及明尼苏达多相人格调查表（MMPI）显示的多种躯体主诉、术后立即报告的严重疼痛、就业情况以及手术时是否存在完全性疝。进一步研究发现有3个因素具有独立重要性，并能解释其他因素：MMPI中的症状量表接纳度（Ad）、当前发作的持续时间以及患者是否就业。在此基础上，我们定义了一组严重心理和社会压力（PASS）患者，其中57%的患者预后不良。其余患者中有5%预后不良。通过术前评估患者是否处于严重心理和社会压力之下，86%的患者手术结果能够被正确预测。
